Impact of Race on Immunization Status in Long-Term Care Facilities

Abstract

Objectives

This study examined the relationship between resident race and immunization status in long-term care facilities (LTCFs). Race was captured at the resident and the facility racial composition level.

Design

Thirty-six long-term care facilities varying in racial composition and size were selected for site visits.

Setting

LTCFs were urban and rural, CMS certified, and non-hospital administered.

Measurements

Chart abstraction was used to determine race, immunization, and refusal status for the 2010–2011 flu season (influenza 1), the 2011–2012 flu season (influenza 2), and the pneumococcal pneumonia vaccine for all residents over 65 years old.

Conclusions

This study found considerable LTCF variation and racial disparities in immunization rates. Compared to Blacks, Whites were vaccinated at higher rates regardless of the LTCF racial composition. Facilities with a greater proportion of Black residents had lower immunization rates than those with primarily White residents. Facility racial mix is a stronger predictor of influenza immunization than resident race. Black residents had significantly higher vaccination refusal rates than White residents for immunization 2. Further studies examining LTCF-level factors that affect racial disparities in immunizations in LTCFs are needed.

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Notes

Acknowledgements

We would like to thank the administration, staff, and residents of the participating long-term care facilities for their willingness to be involved in this research. In addition, we are grateful for the data collection efforts of Jill Chmielewski, Diana Bickham, Margaret Orman, and Harriett Bates while conducting on-site visits to LTCFs across the country. Thanks also to Drs. Scott Williams and Barbara Braun for their many useful comments on this manuscript.

Funding source

This research was conducted through a grant funded by the Centers for Disease Control and Prevention (Grant Number 1U01IP000410-01).